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Simultaneous bilateral hypertensive intracerebral hemorrhages--two case reports
M Kabuto1, T Kubota, H Kobayashi
1Department of Neurosurgery, Fukui Medical School.
Neurologia Medico-Chirurgica
|August 1, 1995
Summary
Simultaneous bilateral hypertensive intracerebral hemorrhages are rare and often lead to poor outcomes. Conservative therapy resulted in severe disability or death in these cases, highlighting the need for careful surgical consideration.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Hypertensive intracerebral hemorrhage is a common cause of stroke.
- Bilateral involvement is less common than unilateral hemorrhage.
- Prompt diagnosis is crucial for patient management.
Observation:
- Two patients presented with simultaneous bilateral hypertensive intracerebral hemorrhages: a 65-year-old male with putaminal hemorrhages and an 80-year-old female with thalamic hemorrhages.
- Computed tomography confirmed the hematomas shortly after symptom onset.
- Both patients received conservative management.
Findings:
- The male patient died within 4 days of onset.
- The female patient progressed to a vegetative state.
- Bilateral intracerebral hemorrhages are associated with poor prognosis, including disturbed consciousness, tetraparesis, and pseudobulbar palsy.
Implications:
- Conservative management of simultaneous bilateral hypertensive intracerebral hemorrhages is often associated with devastating outcomes.
- Surgical intervention may be considered for select patients with smaller hematomas and potential for good functional recovery.
- Further research is needed to establish optimal treatment strategies for this rare condition.